AMAÇ: COVID-19 salgınının fiziksel etkilerinin yanında; hem hastalık kavramının hem de alınan tedbirlerin ruh sağlığı kliniklerinde takip edilen çocuklar üzerindeki etkilerinin dikkatle izlenmesi ve ortaya konması çok önemlidir. Çalışmamızda, pandemi öncesi ve pandemi sırası dönemlerdeki çocuk psikiyatrisi poliklinik başvurularının karşılaştırılarak pandeminin hasta profili ve poliklinik pratiğine etkilerinin ortaya konması amaçlanmıştır.GEREÇ VE YÖNTEM: Türkiye’de ilk COVID-19 vakasının bildirildiği 11 Mart 2020 tarihinden önceki (pandemi öncesi [PÖ]) ve sonraki 14 aylık dönem (pandemi sırası [P]) boyunca üniversitemizin çocuk psikiyatrisi polikliniğine yapılan girişlerin tamamı geriye dönük olarak incelenmiştir. P’nin ilk 7 ayı “pandeminin ilk dönemi (PİD)”, son 7 ayı ise “pandeminin son dönemi (PSD)” olarak ayrıca araştırılmıştır. Tüm hastaların yaşları, cinsiyetleri ve psikiyatrik sorunları ayrıntılı olarak kaydedilmiş ve karşılaştırılmıştır.BULGULAR: Toplam poliklinik başvuru sayısı PÖ’ne göre P’de %45,9 azalmış; PİD’ne göre PSD’nde %82,5 artmıştır. Tanılar özelinde başvuru sayıları PÖ’ne göre P’de; dikkat eksikliği ve hiperkativite bozukluğu ve depresif bozukluklar için belirgin azalma, obsesif-kompulsif bozukluk, anksiyete bozuklukları, özgül öğrenme bozukluğu ve kişilik bozuklukları için belirgin artış göstermiştir (her biri için p<0,001). PİD’ne göre PSD’nde ise başvuru sayıları; kişilik bozuklukları için artış, davranım bozukluğu, obsesif-kompulsif bozukluk ve anksiyete bozuklukları için azalma göstermiştir (her biri için p<0,001).SONUÇ: COVID-19 pandemisinin getirdiği psikolojik stresörlere rağmen P’de poliklinik başvurularının azalmış olması bu kişilerin ihtiyaçları olmasına rağmen psikiyatrik desteğe yeterince ulaşamadıklarını göstermektedir. PSD’nde poliklinik başvurularında oldukça keskin bir artış izlenmesi de, uzun dönemde ruh sağlığı desteğine olan talebin artabileceğini vurgulamaktadır. Psikiyatrik sorunların COVID-19 pandemisinden nasıl ve ne ölçüde etkilendiğini tam olarak ortaya koyabilecek geniş kapsamlı uzunlamasına izlem çalışmalarına ihtiyaç vardır.
Given the lack of studies focusing on this topic, we aimed to evaluate the dimensional personality characteristics of adolescents with Major Depressive Disorder based on the DSM-5 and to determine the relationship between pathological personality traits and psychopathology. This study was done in Turkish population and data of 70 female patients ranging in age between 11 and 18, who were admitted to the Child and Adolescent Psychiatry outpatient clinic with depressive symptoms, was analyzed. We cross-sectionally analyzed DSM-5 Personality Inventory Child Form-Short Version (PID-5-CSV) dimensional scores and the correlation between PID-5-CSV and Beck Depression Inventory (BDI) scores, and compared the PID-5-CSV features between depression severity groups that were formed based on the BDI cutoff ranks. A positive correlation was found between depression severity and total scores of the PID-5-CSV, indicating an increased risk of personality psychopathology. Some of the dimension scores were also positively correlated with BDI scores, putting these patients at risk for specific personality disorders (PD), especially Borderline PD. Significantly lower Antagonism dimension scores were found, which has not been reported in the literature before; this may indicate a possible risk factor for Avoidant PD. Results from this study may suggest that the PID-5-CSV is an effective way to assess personality traits and implement dimensional personality characteristics into the psychiatric diagnosis and treatment process. Studies with control groups and mixed gender samples are needed for further clarification in this field.
Fahr syndrome (FS) is a rare disorder where bilateral, almost symmetric, calcium and other mineral deposits occur in basal ganglia, cerebellar dentate nucleus and white matter. The clinical pattern is variable and may be associated with neuropsychiatric symptoms, seizures, cerebellar or extrapyramidal dysfunction and dementia. In this study, it was aimed to present FS diagnosed with schizophrenia for many years with misdiagnosis in the context of literature information. FS can sometimes be detected without symptoms. The brain computed tomography (BCT) is the best useful diagnosis method.
Background/Aim: The relationship between major depressive disorder (MDD) and specific brain regions was investigated using neuroimaging methods. Although the findings show structural hemispheric asymmetry, research has often focused on the specific brain region involved in MDD. This study aimed to investigate asymmetry in the brain regions of MDD patients for the first time with volBrain, which is a fully automated segmentation technique. Methods: Our study was designed as a case-control study. Structural asymmetry was evaluated using the current web-based fully automated segmentation algorithm, volBrain, that analyzes volumetric T1 axial magnetic resonance imaging data. Sixteen cases with MDD and 14 healthy controls were analyzed. For comparison of continuous data between binary groups, an independent T-test was used for data that follow a normal distribution and Mann-Whitney U (MWU) test was used for data that did not follow a normal distribution while categorical data were evaluated using Chi-square test (or Fisher's exact test when needed). Results: There was no significant difference in terms of gender (χ2 [1, n = 30] = 0.117, P = 0.732), education level (2 [1, n = 30] = 0.002; P = 0.961] and marital status (P = 0.596, Fisher exact chi-square test). However, both groups were found to be similar in terms of age (P = 0.608, MWU test). Right/left nucleus caudatus volume ratios (P = 0.028, MWU test) and right/left cerebellum volume ratios were significantly smaller in the case group (P = 0.006, independent T-test). When the volumes of the right and left parts were compared, only the volume of the right globus pallidus was larger (statistically significant) in the case group (P = 0.008, independent T-test). Conclusion:In line with our hypothesis, our study supports the notion of cortico-striatal-pallidalthalamic circuit abnormalities in current MDD research and found that some regions in this phase may contain structural asymmetry. In addition, this study contributed to the literature consisting of studies that have examined the relationship between cerebellum and MDD by adding that the cerebellum may show structural asymmetry. The results of our study suggest that research using volBrain may be beneficial to patients with MDD. Current web-based fully automatic segmentation algorithms can restrict both the raterinduced differences in manual segmentation applications and the differences that various segmentation algorithms can create. The challenge of multicenter research can be overcome by using web-based fully automated segmentation volumetry systems and data containing the same standardized magnetic resonance imaging (MRI) acquisition parameters because it is easy for clinicians around the world to access webbased fully automated segmentation volumetry systems. Research on fully automatic segmentation techniques might be the driving force behind fully understanding biological foundations of MDD in the future.
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